Objective To Explore the clinical features of early-onset severe preeclarapsia and provide clinical, evidence for early diagnosis, prognosis and termination of pregnancy. Methods 243 cases of severe preeclampsia fromjanuary 2009 to June 2011 in Gulouhospital were devided into two groups; the early onset group ( n = 74 ) and the late onset group ( n = 169 ). The general conditions, laboratory parameters, complications of pregnancy, outcomes of mothers and children were collected and the risk factors of adverse pregnancy outcomes of early-onset severe preeclampsia were analyzed by multifactor Logistic regression. Results No significant differences were found between the two groups in the average age,gravidities,parities and systematically antenatal checks (P >0.05) ,but significant differences were found in gestional ages at the onset of severe preeclampsia, delivery ages, and pregnant body mass index between the two groups. White blood cell count, red blood cell count,hematocrit,Alanine aminotransferase levels (ALT) ,Urea nitrogen levels ( BUN) ,creatinine levels (Cr) ,and Diastolic blood pressure levels in the early onset group were significantly higher than those in the late onset group. The platelet count and Plasma total protein levels in the early onset group were significantly lower than those in the late onset group. No significant differences were found between the two groups in the Systolic blood pressure levels. The incidence of nervous system symptoms.digestive system symptoms,fundus hemorrhage, liver damages,hypoalbuminemia,palacental abruption,heart failure,and HELLP syndroms of mothers in the early onset group were significantly higher than those in the late onset group. The incidence of fetal growth retriction,fetal distress,premature delivery,newboms die and stillbirth in the early onset group were significantly higher than those in the late onset group. The higher red blood cell count, the lower platelet count and the higher alanine aminotransferase levels, the more likely abnormal outcomes of mothers and children in the early onset group. Conclusion It is of great significance to master the clinical characteristics of ES-PE, positively predict the adverse pregnancy outcome risk factors, balance the interests of both mothers and children and timely terminate pregnancy in improving the prognosis of mothers and children.%目的 探讨早发型重度子痫前期的发病特点,为早期诊断、预测预后、选择适宜孕周终止妊娠提供临床依据.方法 回顾性分析2009年1月至2011年6月重度子痫前期243例(早发型74例,晚发型169例)的一般情况、临床实验室指标、妊娠并发症及母婴结局,对早发型组不良妊娠结局的病例进行危险因素的Logistic多因素回归分析.结果 两组孕妇平均年龄、孕次、产次、系统产检方面,差异无显著统计学意义(P＞0.05),但两组人院孕周、分娩孕周、孕前身高体重指数差异有统计学意义；早发型组的白细胞计数、红细胞计数、血细胞比容、转氨酶水平、尿素氮、肌酐及舒张压均明显高于晚发型组,而血小板、血浆总蛋白均低于晚发型组,两组收缩压无明显差异；早发型组孕妇发生神经系统症状、消化系统症状、眼底改变、肝功能损害、低蛋白血症、胎盘早剥、心力衰竭及溶血、肝酶升高、血小板减少综合征的发生率均高于晚发型组；早发型组胎儿生长受限、胎儿窘迫、早产、新生儿死亡及死胎等发病率明显高于晚发型组；早发型重度子痫前期红细胞计数越高、血小板计数越低、转氨酶水平越高,越有可能出现母儿异常结局.结论 掌握早发型重度子痫前期临床特点,积极预防预测不良妊娠结局的危险因素,找到母婴双方利益的平衡点,及时终止妊娠对改善母儿预后有重大意义.
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